The Effect of Acute Psychologic Stress on Systemic and Rectal Mucosal Measures of Inflammation in Ulcerative Colitis
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Background & aims Recent studies suggest that life events and chronic stress increase the risk of relapse in inflammatory bowel disease. Our aim was to study the effects of acute psychologic stress on systemic and rectal mucosal inflammatory responses in patients with inactive ulcerative colitis (UC).Methods Twenty-five patients with inactive UC and 11 healthy volunteers (HV) underwent an experimental stress test. Ten patients with UC and 11 HV underwent a control procedure. Before and after each procedure, systemic inflammatory response was assessed by serum interleukin (IL)-6 and IL-13 concentrations, tumor necrosis factor (TNF)-alpha and IL-6 production by lipopolysaccharide (LPS)-stimulated whole blood, leukocyte count, natural killer (NK) cell numbers, platelet activation, and platelet-leukocyte aggregate (PLA) formation. In patients with UC, rectal mucosal inflammation was assessed by TNF-alpha, IL-13, histamine and substance P release, reactive oxygen metabolite (ROM) production, mucosal blood flow (RMBF) and histology.Results Stress increased pulse (P < .0001) and systolic BP (P < .0001). In UC, stress increased LPS-stimulated TNF-alpha and IL-6 production by 54% (P = .004) and 11% (P = .04), respectively, leukocyte count by 16% (P = .01), NK cell count by 18% (P = .0008), platelet activation by 65% (P < .0001), PLA formation by 25% (P = .004), mucosal TNF-alpha release by 102% (P = .03), and ROM production by 475% (P = .001) and reduced rectal mucosal blood flow by 22% (P = .05). The control protocol did not change any of the variables measured. There were no differences between the responses of the patients with UC and HV.Conclusions Acute psychologic stress induces systemic and mucosal proinflammatory responses, which could contribute to exacerbations of UC in ordinary life.
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Stress reactivity preceded mucosal release in UC.
“though the latter study found stress reactivity preceded mucosal release.”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [49]
The Stress/Control Protocol section records pulse and blood pressure during the stress test, followed by collection of rectal perimucosal fluid after the test. The Rectal Perimucosal Fluid Cytokine Levels section reports increased TNF-α after stress. This establishes the order of measurements, but not that the physiological stress response preceded the onset of mucosal release. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPerceived stress was not associated with mucosal release in UC.
“nor mucosal release 49 in UC”
From Systematic review: the role of psychological stress in inflammatory bowel disease (2022) · cites this paper as [49]
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References 52 · Cited by 143
- Authors
- Mawdsley, J. E., Macey, M. G., Feakins, R. M., Langmead, L., & Rampton, D. S.
- Affiliations
- Queen Mary University of London (GB)
- Barts Health NHS Trust (GB)
- University College Hospital (GB)
- Corresponding author
- Rampton, David S.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2006-08
- Volume
- 131
- Issue
- 2
- Pages
- 410-419
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2092894230
- Cited by
- 143
- References
- 52
- Citations by year
- 2025: 6 · 2024: 6 · 2023: 8 · 2022: 11 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 8 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 6 · 2013: 11 · 2012: 8
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Blond McIndoe Research Foundation
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- ulcerative colitis, systemic inflammation, interleukin-6, IL-13, TNF-α, platelet activation, platelet-leukocyte aggregates, natural killer cells, reactive oxygen species, mucosal blood flow, substance P, histamine
- MeSH terms
- Acute Disease, Adult, Blood Flow Velocity, Colitis, Ulcerative, Enzyme-Linked Immunosorbent Assay, Female, Flow Cytometry, Follow-Up Studies, Histamine, Humans, Intestinal Mucosa, Leukocyte Count, Male, Middle Aged, Surveys and Questionnaires, Rectum, Severity of Illness Index, Stress, Psychological, Substance P, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Disease Progression, Interleukin-13
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